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The general practitioner's use of time: Is it influenced by the remuneration system?


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  • Kristiansen, Ivar Sønbø
  • Mooney, Gavin
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    The practice pattern of 116 general practitioners in 60 rural municipalities in Northern Norway was studied with respect to length of consultation, the weekly number of consultations and the proportion of return visits. The average length of consultation was 14 mins, and only slightly lower for fee-for-service (FFS) doctors (13.7) than for salaried ones (14.8). The weekly average number of surgery consultations was higher for FFS doctors than for the salaried (63 vs 49), but the weekly number of hours spent consulting and the proportion of return visits were about the same. Further, the characteristics of the health care system (doctor density and doctor turnover) were associated with variations in the doctors' use of time. The most consistent effects, even if weak, were the age and sex of the patients. The strongest effects on the length of consultation were referrals and various medical procedures. This suggests that in this instance the medical condition at hand would appear to have a greater influence on the doctors' use of time than either the remuneration system or other characteristics of the health care system. Although the association between the doctors' use of time and the type of remuneration was weak, the study indicates that the type of remuneration does matter. Consequently, financial incentives can be used to influence the practice pattern of GPs.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 37 (1993)
    Issue (Month): 3 (August)
    Pages: 393-399

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    Handle: RePEc:eee:socmed:v:37:y:1993:i:3:p:393-399

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    Keywords: general practice remuneration system use of time length of consultation;


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    Cited by:
    1. Schuster, Stephan, 2012. "Applications in Agent-Based Computational Economics," MPRA Paper 47201, University Library of Munich, Germany.
    2. Mauricea Lynch & Michael Calnan, 2003. "The changing public|private mix in dentistry in the UK-a supply-side perspective," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 309-321.
    3. Devlin, Rose Anne & Sarma, Sisira, 2008. "Do physician remuneration schemes matter? The case of Canadian family physicians," Journal of Health Economics, Elsevier, vol. 27(5), pages 1168-1181, September.
    4. Godager, Geir, 2009. "Four Empirical Essays on the Market for General Practitioners' Services," HERO On line Working Paper Series 2009:7, Oslo University, Health Economics Research Programme.
    5. Scott, Anthony & Hall, Jane, 1995. "Evaluating the effects of GP remuneration: problems and prospects," Health Policy, Elsevier, vol. 31(3), pages 183-195, March.
    6. Geir Godager & Hilde Lurås, 2009. "Dual job holding general practitioners: the effect of patient shortage," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1133-1145.
    7. Samuel E.D. Shortt & Michael E. Green & C. Keresztes, 2005. "Family Physicians for Ontario: An Approach to Production and Retention Policy," Canadian Public Policy, University of Toronto Press, vol. 31(2), pages 207-222, June.
    8. Christel Dijk & Robert Verheij & Hans te Brake & Peter Spreeuwenberg & Peter Groenewegen & Dinny Bakker, 2014. "Changes in the remuneration system for general practitioners: effects on contact type and consultation length," The European Journal of Health Economics, Springer, vol. 15(1), pages 83-91, January.


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